Provider Demographics
NPI:1003247040
Name:MANGO STAFFING AND BILLING INC
Entity Type:Organization
Organization Name:MANGO STAFFING AND BILLING INC
Other - Org Name:MANGO HOME HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAXA
Authorized Official - Middle Name:
Authorized Official - Last Name:BHATT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-505-0080
Mailing Address - Street 1:1403 OAKWOOD HOLLOW LANE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755
Mailing Address - Country:US
Mailing Address - Phone:732-505-0080
Mailing Address - Fax:732-505-0083
Practice Address - Street 1:1403 OAKWOOD HOLLOW LANE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-505-0080
Practice Address - Fax:732-505-0083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJHP0132900251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0275972Medicaid
NJ=========OtherEIN